Video presented by PTZ regular contributor Dr. K**ZIT** von lmellick – one of the biggest arm abscesses he’s seen… wonder if he has watched all the videos here on PTZ… 🙂 Convert! Convert!

YT Commentary:

“This video demonstrates the incision and drainage of a huge arm abscess. This is one of the largest arm abscesses that I have ever seen. The procedure was very painful to the patient despite intravenous narcotics and local anesthesia.”

61 comments

Anytime your not able to fully release all of the material inside your going to want to pack it. You need to keep the wound open because wounds will close the outside skin first and leave a “pocket” inside where more pus can ac**ZIT**ulate. When that happens you just end up having to repeat the I&D again. By packing it, you allow the wound to heal from the inside out and your making sure that all the pus & necrotic tissue is removed.

You can place a dressing on it when it’s really shallow, or when you have something like a sebaceous cyst where you have removed the entire cyst including the sac wall. Those won’t reoccur, so it’s safe to allow natural closing or to put a s**ZIT**ch or two in.

OMG what a m**ZIT**ive abscess, amazing pus flow. The shape and size of it looked like an extra breast to me! I was also extremely happy to read that the MD had provided intravenous narcotic in addition to the local.

Overall very nice job. I wish that I could have seen more, it’s obvious that she was still retaining significant amount of pus. I think they packed her early due to pain intolerance (just guessing). It’s definitely a keeper!

from where we were sitting, it looked like there was a big juicy pus blob just waiting to come out. I thought maybe the same thing, that they stopped because of the patient pain. As nice as it would have been to see it to completion, her comfort is more important 🙂

Hmmm…I never like to criticize a fellow Physician’s work, but…it looked to me like that bad boy still had a LOT more goo to come out of there. That was the most p**ZIT**ive debriding I think I have ever seen!
I think I would have opened that thing up with the “football incision” and cleaned that thing out good. As it is it appears that it will take three timeslonger to heal than if he had really cleaned it out good.
Then again…we never know how strongly the patient may have fought him over a more thorough procedure. For all we know that is all he was ALLOWED to do. Just sayin’…

Ok, I thought my imagination was running wild – the skin color WAS green because of the huge amount of green pus underneath the skin!!!!! It looked somewhat pink when they started to pack it but it there was still a good hint of green puke mushy pus that the Dr needed to insert a finger and break it up. That is one time you need to put the patient to sleep and make sure the infection is cleaned out. Surprised the middle of the abscess did’t break open on its own because it didn’t take much to break that skin open. Can you imagine moving your arm to have your shirt SOAKED, i mean SOAKED in green pus?!?!? GREAT find!!!!

Thank goodness I’ve never had an abcess but I do have a dumb question: if the pus if green like in this video does that mean the pus has been in there for a long time? Lots of pus is creamy white or yellowish; this green looked extra nasty and painful. Guess something like that won’t heal itself with antibiotics?

To answer your question, the color is caused by the body’s natural defense system of neutrophils attacking the bacteria’s. The green color is caused by a protein that is released to help your body fight the infection, sometimes it is caused by the bacteria itself, such as with pseudomonas and that one can get really really dark. It also smells really bad, very distinctive, so if you get a whiff you can probably tell if it’s just the regular neutrophil or the pseudomonas (kinda like C-diff…once you smell it you never forget it, don’t even need the cultures).

As for healing with antibiotics…did you mean “wouldn’t heal”? Because antibiotics are definitely called for in this case, probably a Beta-Lac and also an Aminoglycoside. Culture it and then initiate, when the final sensitivity comes back then you can tweak the antibiotic coverage if needed. (Just my opinion)

yes, I did mean it won’t heal itself without antibiotics – thanks for the explanation on the color of pus. I’ve never smelled an absess but from the many videos I’ve seen on PTZ, lots of the poppers and poppees comment on the terrible smell.

Thanks so much, Splashpopbong for your contribution to my evening enjoyment! I wonder if the patient will return for this procedure to continue, as there seemed to be so much infection left in the wound.

Yeah…probably to change the packing poppy!
Because this abscess was kinda big,it will need to be repacked.
I’m no medical professional and this is just my opinion.

In the YT Commentary,the Dr said it was the biggest abscess hes ever seen…This good Doctor (cuz he/she is really good from what we saw in the small vid) should come on PTZ….the archives is full of “mega-big” abscess… 😉

Yes, I think of the guy in Mexico or S. America whose arm was swimming in green pus!!! I think there was more green pus in his body than blood. I wonder what happened to that poor guy – the infection was MIND BOGGLING!!!

Loads and loads of green infection! That had to hurt sooo bad!! I felt really sorry for her….. It did seem like too much was left in there, including the destroyed sac! Maybe it was because of the extreme pain, like Cindi said…! Thank you for an awesome post splashpabong! Keep up the good mining!

Cysts are usually painless, benign and not infected. They are often present for years and typically don’t cause any problems other than just knowing that they are there. They can become painful & infected at which time they need to come out.

An abscess is a fluid filled pocket that is painful and typically filled with bacteria that will require antibiotic coverage. Just depends on location, type of abscess and cultures. I’ve seen a few tiny ones that you could just I&D and be done with it, but every abscess of significant size that I’ve personally encountered required at least some antibiotic coverage. With a cyst you don’t typically give antibiotic unless it had become infected.

I’ve got a Sebaceous cyst on the (L) Posterior Scalp that has been there since I was a baby. In the past year or so it’s been growing a little more, but I hardly ever notice it unless it gets **ZIT**ped when brushing/shampooing hair. It’s completely harmless and that’s why I haven’t had it removed. It has grown a little this past year, I can palpate an area about the size of a Walnut, but unless it gets infected I don’t intend to do anything with it. It’s been there for more than 40 years without any issue, I don’t see the point in disturbing it now.

I’ve had post operative abscess formation after a laproscopic procedure. One of the Trochar sites became infected, but it was benign as well. No erythremia, no discharge, no fever..nada. Just more pain that what I should have had. Went to the ER and the triage nurse thought I was drug seeking. Damn thing bust open while I was getting checked in and poured several cups worth of nice green pus everywhere. Needless to say I bought myself a CT Scan that day. Anyway, those are the differences between them based on my knowledge.

The music is a nice touch.
Poor patient – grabbing at the doc like that. I grabbed at a dentist who was causing me a lot of pain during a procedure once. It really ticked him off.
This is so swollen! It hurts me to think of squeezing it, but I think the doc went a little too easy on breaking up the pockets inside. It’s a tough decision.

This video is the reason I keep coming back, day after day. We often go weeks with a pimple or two, and maybe a boil that looks promising. And either the camera person forgets they are do**ZIT**enting an event, or it lasts 30 seconds. Far too short. This one has it all. Great shots of our secret obsession, and even mood music. I can go to bed a happy camper. Thanks muchly, Splashpopbong. I am a happy and contented man tonight. Oh, and I’m glad too see there were others who thought it looked like a breast too. lol
Prunesquallor

I agree with you…Definitely more in there. Also this clip was obviously downsized. That could have been nominated for an Emmy if entire drainage was shown. However, when the Dr. had the hemostats in there did you notice that white tissue ? Was that part of the muscle of a sac from the pus? I would have liked to see all the chunks that were flushed out… The packing was so long (yes I understand it was a huge hole in there) but wouldn’t be better or less painful to pack it with maybe a 4×4 gauze sponge?

I know I’ve already commented on this one, but I cannot stop watching it!! That thing is SSSOOOOO HUGE!!! I feel so bad for the patient, however, I am happy that they recorded & shared this! Unbelievable!! I do hope that the patient has made a full recovery! Thanks for the great find Splashpopbong!! An instant cl**ZIT**ic & definitely in my top 3 all-time favorites!! 😀

34 yrs ego I had an abscess of about that size!After about 7-8 days it became nice and ripe!So I set into the Bathtub full of hot water.Threw in a bag of Epsom Salt and socked it for 25-30 minutes!Than using a Sterile,Surgical Scalpel,I found the soft spot and gently cut into it!Well let me tell you,the Water immediately turned greyish green!And as the pressure was released,the pain got relived immediately!!!This upload brought those Memories back up lolololololololol

I can feel for the patient. I had an abdominal wall abscess that almost killed me (pain and health). It was so bad I couldnt even walk the 2 feet from my bedroom to my bathroom. Seeing that brought back memories. Hope the patient is ok now.

Hey everyone, thanks for all the views. This is the closest I think I will ever get to going viral and it is not even my vid. The only thing I ever saw nearly 10,000 times was my cat LOL. Again, thanks for the views.